- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.97 / $2.54 / $2.90
| Facility | | $1.97 | $2.54 | $2.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.23 / $2.59 / $3.56
| Professional | | $2.23 | $2.59 | $3.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.06 / $2.24 / $2.50
| Facility | | $2.06 | $2.24 | $2.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.88 / $2.10 / $2.10
| Professional | | $1.88 | $2.10 | $2.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.44 / $3.15 / $3.94
| Professional | | $2.44 | $3.15 | $3.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.94 / $3.94 / $3.94
| Facility | | $3.94 | $3.94 | $3.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.60 / $2.60 / $2.68
| Facility | | $2.60 | $2.60 | $2.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.89 / $2.21 / $2.60
| Professional | | $1.89 | $2.21 | $2.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $80.00 / $80.00
| Facility | | $80.00 | $80.00 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.32 / $22.86 / $34.72
| Professional | | $22.32 | $22.86 | $34.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.26 / $2.95 / $3.94
| Facility | | $1.26 | $2.95 | $3.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.41 / $3.62 / $3.94
| Professional | | $2.41 | $3.62 | $3.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.26 / $2.81 / $3.94
| Facility | | $1.26 | $2.81 | $3.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.89 / $2.21 / $3.45
| Professional | | $1.89 | $2.21 | $3.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.64 / $2.13 / $2.81
| Professional | | $1.64 | $2.13 | $2.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.31 / $2.31 / $3.94
| Professional | | $2.31 | $2.31 | $3.94 |